Welcome to this space spanning the body, heart, mind, and spirit

First up is The Pill: It's Complicated

This is a space for holistic approaches to health, from the clinical to the spiritual.

I’m inspired to share my work as an integrative medical practitioner, yet social media platforms feel uninviting to conversations about such nuanced, sensitive topics.

So, I’ve turned to a more intimate venue where I hope to create a space of safety and belonging for dialogue open to a range of experiences and perspectives. Starting with… the pill.

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A Polarizing Little Pill

There has been a lot of conversation around the recent National Geographic article discussing safety of the birth control pill.

The topic of safety came up during a local reproductive health panel this spring that I participated in. When the moderator asked us if the pill is safe, I honestly froze. It gave me pause because it is so important to be thoughtful about how we approach this discussion. 

It is complex and can be polarizing. People who struggle with the pill’s side effects often feel dismissed by their providers when they raise concerns. And folks with positive experiences on the pill sometimes feel judged for taking it!

When people ask what the best form of contraception is, I say that there isn’t one. What is “best” for my needs and goals may be very different than what is “best” for the person next to me.

Informed Consent

So many of us have been prescribed the pill without informed consent, which includes understanding the risks, side effects, benefits and how the medication works. This is concerning - especially for a medicine that people may be on for 10 or 15+ years.

When I was 16 years old I had an abortion. My pediatrician hugged me and cried with me at my followup appointment. I was so grateful for her compassion. She prescribed me the pill to prevent another unplanned pregnancy, but we never discussed risks and side effects. I had no clue how this daily medication affected my hormones or my body’s ecosystem.

Years later when I developed severe mood and skin changes consistently before my period, I intuitively felt it was due to the pill. I felt so unheard when my new doctor told me it wasn’t related to the medication, and offered me anti-depressants. I left the visit feeling gaslit for a well-documented side effect. If I had been informed of these effects, I might have felt better prepared to advocate for myself. Interestingly, my symptoms improved when I stopped the pill…

Language Matters

In order to understand how the pill affects us, we need to discuss it accurately. The National Geographic article explains how the pill “can make your period more regular.” But breakthrough bleeding on the pill is not a period. This rhetoric confuses and misleads patients into thinking that they are menstruating when they are not.

And I invite us to explore what we mean by “safe.” While mortality rates do not demonstrably increase from the pill, side effects with major impact like depression still exist. Where do we draw the line for what we define as tolerable? For what we define as safe?

Dr. Aviva Romm is a family medicine doctor, midwife, and herbalist who recently discussed the myths and realities of the pill in her blog and podcast.  She addresses the real side effects and risks, including supporting clinical data. She also acknowledges that the pill is the appropriate option for some folks - again, based on their individual goals and needs. 

There are people who understand how the pill affects their hormones, are comfortable with it, and make an informed decision to take it. I know plenty of folks who report no side effects, which is wonderful.

And many people are not comfortable with how the pill works. They want to connect to their body’s cyclical rhythms. I love feeling the shifts in my energy between the different phases of my menstrual cycle. It helps me listen closely to my body, and gives me grace and an openness to rest when I need to. I might not always feel 100% all of the time, but I do feel aligned.

What Contraception is Right for Me?

Start researching all the options. Read about the pros and cons of the pill, ring, implant, injections, IUD, barrier methods like condoms, and fertility awareness. Talk to friends about their experiences. Start a dialogue with your healthcare provider discussing your questions and concerns. If your provider doesn’t have the answers or isn’t familiar with a specific option, talk to more providers who do.

The Bottom Line

In order to make health decisions aligned with our values and needs, we must understand all our options and how they affect us.

The “best” contraception for me may be different than the “best” for you.
And that’s okay.